,3 However, an increasing body of evidence demonstrates moderate AS to portend an almost equivalent adverse event rate compared with untreated severe AS, particularly in the presence of impaired diastolic function and/or elevated B-natriuretic peptide levels.4, 5, 6, 7 Current guidelines recommend these patients undergo surveillance imaging every 1 to 2 years, and only recommend AVR for moderate AS if patients are to undergo open heart surgery for a separate indication (Class 2B).1 Here, NPPB is linked to aortic stenosis.